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I read with interest the excellent article by Harrison et al¹ on low-molecular-weight heparin (LMWH) for outpatient treatment of patients with deep venous thrombosis (DVT). In clinical studies on the prevention and treatment of DVT, LMWH proved at least equal and in some cases superior to unfractionated heparin in efficacy and safety.^2-3

This success of LMWH in the management of DVT has prompted several investigators to study the use of LMWH in acute coronary syndromes. Three recently completed trials—the FRagmin during InStability in Coronary artery disease study (FRISC),⁴ the Efficacy and Safety of Subcutaneous Enoxaparin in Non–Q-wave Coronary Events study (ESSENCE),⁵ and the FRagmin In unstable Coronary artery disease study (FRIC)⁶—concluded that treatment of patients with unstable angina with LMWH is at least as effective as and potentially more effective than with unfractionated heparin.

In addition to the favorable results comparing LMWH with unfractionated heparin based on the STEP . . . [Full Text of this Article]

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